Provider Demographics
NPI:1780557843
Name:GRAHAM, SAMISTA MAHARJAN
Entity type:Individual
Prefix:
First Name:SAMISTA
Middle Name:MAHARJAN
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10058 MARMOT CIR UNIT B
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-2345
Mailing Address - Country:US
Mailing Address - Phone:972-207-3081
Mailing Address - Fax:
Practice Address - Street 1:10058 MARMOT CIR UNIT B
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-2345
Practice Address - Country:US
Practice Address - Phone:972-207-3081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK243970367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered